Individual
MATTHEW RYAN QUALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-BC
Contact information
Practice address
3550 US ROUTE 60 E, BARBOURSVILLE, WV 25504-1639
(304) 736-9090
Mailing address
208 REYNOLDS ST, HURRICANE, WV 25526-1145
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP85005751
CA
363LF0000X
Family Nurse Practitioner
Primary
APRN83720-FNP-BC
WV
Other
Enumeration date
07/26/2016
Last updated
10/24/2018
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